In the field of orthopedic surgery, in particular minimally invasive orthopedic surgery, the physician often works through a very small incision, a small cannulated tube or a retractor. Since the working space for the surgeon is a small confined channel, specialized instruments are necessary to safely navigate the distance from outside the skin of the patient to adjacent the surgical site within the body of the patient. These specialized instruments, depending on the type of surgery, may include custom rongeurs, rasps, curettes and spinal device insertion instruments.
When performing an orthopedic joint replacement surgery, in particular intervertebral disc or nucleus replacement surgery, it is often difficult to properly and confidently position an implant in the position desired by the surgeon. It is desirable to utilize an implant insertion instrument that firmly holds the implant, while allowing the surgeon to release the instrument to safely perform fluoroscopy. It is also desirable, after fluoroscopy, to be able to redirect, manipulate and release the implant percutaneously once the desired position of the implant has been achieved.
When performing an intervertebral disc or a nucleus replacement surgery, the surgeon may have a preference for, or patient anatomy may dictate, the origin and direction of entry into the body of the patient including anterior, lateral, or posterior approaches. Each method of entry presents the surgeon with specific challenges that are typically met with instruments corresponding to the decided method of entry. It would be desirable to have a spinal implant insertion instrument that would meet the specific surgeon challenges of anterior, lateral and posterior methods of entry.
Manipulating and steering a multiple piece implant presents additional challenges. It is desirable to be able to both steer a multiple piece implant, such as a two-piece motion preserving nucleus replacement device (NRD), while allowing for independent movement between the various pieces for promoting ease of insertion of the device. Thus, an implant and corresponding insertion instrument capable of reliably, safely, and simply gripping, steering, and releasing an implant, while allowing for the implant to be configured in a compact orientation is desirable.
Another problem in the art is the cleanability of surgical tools. In some circumstances, blood, tissue, or other matter may find its way into difficult-to-access portions of the instrument. While the tool may be sterilized using an autoclave, blood and other foreign matter may still remain within the instrument. Accordingly, it is desirable that an insertion instrument be configured to be cleanable, such as by using hand methods to clean, brush, wash or scrub any foreign matter from the interior of the instrument.